- Email: [email protected]
SARCOPENIA IS ASSOCIATED WITH A REDUCED SURVIVAL IN PATIENTS WITH HEPATOCARCINOMA UNDERGOING SORAFENIB TREATMENT
Abstracts / Digestive and Liver Disease 47S (2015) e43–e66
F-47
F-48
SARCOPENIA IS ASSOCIATED WITH A REDUCED SURVIVAL IN PATIENTS WITH HEPATOCARCINOMA UNDERGOING SORAFENIB TREATMENT
ORAL BACTERIAL LOAD IN AUTOIMMUNE LIVER DISEASES: POSSIBLE ROLE OR COINCIDENCE?
E. Gigante 1 , G. Antonelli 1 , P. Begini 1 , F. Carbonetti 2 , E. Iannicelli 2 , P. Marchetti 3 , L. Miglioresi 4 , A. Pellicelli 4 , G. Delle Fave 1 , M. Marignani 1 1 Digestive and Liver Diseases unit, St. Andrea Hospital, Faculty of Medicine and Psychology, University Sapienza’, Rome, Italy 2 Radiology unit, St. Andrea Hospital, Faculty of Medicine and Psychology, University Sapienza’, Rome, Italy 3 Oncology unit, St. Andrea Hospital, Faculty of Medicine and Psychology, University Sapienza’, Rome, Italy 4 Liver Unit, San Camillo-Forlanini Hospital, Rome, Italy
Background and aim: Sarcopenia has been associated with poor outcomes in patients with cirrhosis and solid tumors, and with higher toxicity during chemotherapy. Hepatocarcinoma (HCC) is diagnosed at advanced stage in up to 40% of all patients. At this stage, the only approved treatment is Sorafenib. We analyzed the influence of sarcopenia on survival of HCC patients treated with Sorafenib. Methods: We conducted a retrospective study on 41 patients with advanced HCC treated with Sorafenib. Enrolled patients performed abdominal computed tomography (CT) 30 days within treatment start, and data regarding survival, treatment toxicity, anthropometric features, and laboratory findings were collected. A transverse CT image from L3 was collected from each scan and analyzed with SliceOmatic 5.0. The muscles’ cross-sectional area at this level were selected and normalized for height, obtaining the skeletal-muscle-index (SMI). Presence of sarcopenia was defined by SMI ≤41 cm2/m2 for women, and ≤53cm2/m2 for men with body mass index (BMI) ≥25, and ≤43 cm2/m2 for those with a BMI <25. Results: Patients were mainly males (80,5%). Sarcopenia was present in 36,5% of patients (15/41). The two groups, with or without sarcopenia were compared. Sex distribution and baselines features were similar, no significant differences in albumin, INR, BMI, Sodium, creatinine, bilirubin and MELD score were detected. Child-Pugh Score was higher in the sarcopenic group [6 (5-8) vs 5 (5-8); p = 0,034]. Sarcopenic patients had reduced Overall Survival 79 (95% CI 44-114) vs 181(95% CI 140-223) weeks (p = 0,0013), as well as smaller survival after treatment: 24 vs 54 weeks(figure 1). Time on treatment of sarcopenic patients was 12,3 vs 22,9 weeks (H.R. 1,83, p = 0,0464), but there were no differences in the cause of interruption. Conclusion: Sarcopenia is present in a third of advanced HCC, and is associated with reduced OS and with reduction of time on Sorafenib treatment. http://dx.doi.org/10.1016/j.dld.2015.01.141
e65
G. Orrù 1 , S. Onali 2 , C. Salustro 2 , S. Cappellini 2 , E. Cocco 1 , S. Fais 1 , M. Melis 1 , A. Gilardi 1 , B. Musu 1 , L. Secci 2 , G. Serra 2 , C. Balestrieri 2 , M. Conti 2 , M. Casale 2 , S. Casu 2 , F. Figorilli 2 , M.C. Pasetto 2 , R. Littera 3 , R. Scioscia 2 , L. Barca 2 , L. Chessa 2 1 DNA Sequencing Service, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy 2 Center for the Study of Liver Diseases, Department of Medical Sciences “M.Aresu”, University of Cagliari, Cagliari, Italy 3 Medical Genetics, Department of Medical Sciences “M.Aresu”, University of Cagliari, Cagliari, Italy
Background and aims: Several factors seem be involved in the pathogenesis of autoimmune liver disease (ALD), such as bacteria or bacterial components. Some studies highlighted the role of an oral bacterium, P. gingivalis, in the pathogenesis of rheumatoid arthritis and in the induction of NASH. We evaluated if there was a correlation between oral bacteria and some features of ALD. Methods: We analyzed 50 patients with ALD, 22 with autoimmune hepatitis (AIH) and 28 with primary biliary cirrhosis (PBC), 94% females, median age 61 years, median disease duration 7.5 years, 18% with cirrhosis, 66% responders to treatment, 40% with concomitant autoimmune diseases, and 46 health controls matched for sex and age. Patients and controls were subjected to cytobrush of the tongue. Exclusion criteria were antibiotic use in the previous week, mouthwash use on the day of inclusion. The study was conducted with the local ethics committee approval and informed consent was obtained from all subjects. Bacterial DNA (BD) obtained from the tongue biofilm was quantified using a computer RNA-DNA and expressed as ug/ml of sample.For each analysis, three distinct biological replicas were done, and quantitative data were expressed as mean ± SD. Results: BD amount was greater in ALD than in controls (1834.10 vs. 881.75, p < 0.0001). There was no correlation between BD amount and age, disease duration, histological findings and biochemical parameters, except for alkaline phosphatase (p = 0.05). The presence of cirrhosis, response to therapy and the immunosuppressive drug use did not affect BD amount. Finally, patients with concomitant autoimmune diseases had a greater BD amount than the other (2053.54 vs. 1687.60) but without significance (p = 0.57). Conclusion: Our study showed an unspecified role of oral bacteria in patients with autoimmune liver diseases. Further analysis will be needed to assess if there are differences in the microbial population. http://dx.doi.org/10.1016/j.dld.2015.01.142
F-47
F-48
SARCOPENIA IS ASSOCIATED WITH A REDUCED SURVIVAL IN PATIENTS WITH HEPATOCARCINOMA UNDERGOING SORAFENIB TREATMENT
ORAL BACTERIAL LOAD IN AUTOIMMUNE LIVER DISEASES: POSSIBLE ROLE OR COINCIDENCE?
E. Gigante 1 , G. Antonelli 1 , P. Begini 1 , F. Carbonetti 2 , E. Iannicelli 2 , P. Marchetti 3 , L. Miglioresi 4 , A. Pellicelli 4 , G. Delle Fave 1 , M. Marignani 1 1 Digestive and Liver Diseases unit, St. Andrea Hospital, Faculty of Medicine and Psychology, University Sapienza’, Rome, Italy 2 Radiology unit, St. Andrea Hospital, Faculty of Medicine and Psychology, University Sapienza’, Rome, Italy 3 Oncology unit, St. Andrea Hospital, Faculty of Medicine and Psychology, University Sapienza’, Rome, Italy 4 Liver Unit, San Camillo-Forlanini Hospital, Rome, Italy
Background and aim: Sarcopenia has been associated with poor outcomes in patients with cirrhosis and solid tumors, and with higher toxicity during chemotherapy. Hepatocarcinoma (HCC) is diagnosed at advanced stage in up to 40% of all patients. At this stage, the only approved treatment is Sorafenib. We analyzed the influence of sarcopenia on survival of HCC patients treated with Sorafenib. Methods: We conducted a retrospective study on 41 patients with advanced HCC treated with Sorafenib. Enrolled patients performed abdominal computed tomography (CT) 30 days within treatment start, and data regarding survival, treatment toxicity, anthropometric features, and laboratory findings were collected. A transverse CT image from L3 was collected from each scan and analyzed with SliceOmatic 5.0. The muscles’ cross-sectional area at this level were selected and normalized for height, obtaining the skeletal-muscle-index (SMI). Presence of sarcopenia was defined by SMI ≤41 cm2/m2 for women, and ≤53cm2/m2 for men with body mass index (BMI) ≥25, and ≤43 cm2/m2 for those with a BMI <25. Results: Patients were mainly males (80,5%). Sarcopenia was present in 36,5% of patients (15/41). The two groups, with or without sarcopenia were compared. Sex distribution and baselines features were similar, no significant differences in albumin, INR, BMI, Sodium, creatinine, bilirubin and MELD score were detected. Child-Pugh Score was higher in the sarcopenic group [6 (5-8) vs 5 (5-8); p = 0,034]. Sarcopenic patients had reduced Overall Survival 79 (95% CI 44-114) vs 181(95% CI 140-223) weeks (p = 0,0013), as well as smaller survival after treatment: 24 vs 54 weeks(figure 1). Time on treatment of sarcopenic patients was 12,3 vs 22,9 weeks (H.R. 1,83, p = 0,0464), but there were no differences in the cause of interruption. Conclusion: Sarcopenia is present in a third of advanced HCC, and is associated with reduced OS and with reduction of time on Sorafenib treatment. http://dx.doi.org/10.1016/j.dld.2015.01.141
e65
G. Orrù 1 , S. Onali 2 , C. Salustro 2 , S. Cappellini 2 , E. Cocco 1 , S. Fais 1 , M. Melis 1 , A. Gilardi 1 , B. Musu 1 , L. Secci 2 , G. Serra 2 , C. Balestrieri 2 , M. Conti 2 , M. Casale 2 , S. Casu 2 , F. Figorilli 2 , M.C. Pasetto 2 , R. Littera 3 , R. Scioscia 2 , L. Barca 2 , L. Chessa 2 1 DNA Sequencing Service, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy 2 Center for the Study of Liver Diseases, Department of Medical Sciences “M.Aresu”, University of Cagliari, Cagliari, Italy 3 Medical Genetics, Department of Medical Sciences “M.Aresu”, University of Cagliari, Cagliari, Italy
Background and aims: Several factors seem be involved in the pathogenesis of autoimmune liver disease (ALD), such as bacteria or bacterial components. Some studies highlighted the role of an oral bacterium, P. gingivalis, in the pathogenesis of rheumatoid arthritis and in the induction of NASH. We evaluated if there was a correlation between oral bacteria and some features of ALD. Methods: We analyzed 50 patients with ALD, 22 with autoimmune hepatitis (AIH) and 28 with primary biliary cirrhosis (PBC), 94% females, median age 61 years, median disease duration 7.5 years, 18% with cirrhosis, 66% responders to treatment, 40% with concomitant autoimmune diseases, and 46 health controls matched for sex and age. Patients and controls were subjected to cytobrush of the tongue. Exclusion criteria were antibiotic use in the previous week, mouthwash use on the day of inclusion. The study was conducted with the local ethics committee approval and informed consent was obtained from all subjects. Bacterial DNA (BD) obtained from the tongue biofilm was quantified using a computer RNA-DNA and expressed as ug/ml of sample.For each analysis, three distinct biological replicas were done, and quantitative data were expressed as mean ± SD. Results: BD amount was greater in ALD than in controls (1834.10 vs. 881.75, p < 0.0001). There was no correlation between BD amount and age, disease duration, histological findings and biochemical parameters, except for alkaline phosphatase (p = 0.05). The presence of cirrhosis, response to therapy and the immunosuppressive drug use did not affect BD amount. Finally, patients with concomitant autoimmune diseases had a greater BD amount than the other (2053.54 vs. 1687.60) but without significance (p = 0.57). Conclusion: Our study showed an unspecified role of oral bacteria in patients with autoimmune liver diseases. Further analysis will be needed to assess if there are differences in the microbial population. http://dx.doi.org/10.1016/j.dld.2015.01.142